Use and Impact of Complementary and Alternative Medicine Among US Children

描述（由申请人提供）：迄今为止，补充和替代医学（CAM）的使用在美国儿童和青少年中越来越普遍。然而，国家的、基于人群的估计和所有儿童和不同亚组的辅助治疗使用的相关性尚不清楚。尤其不完整的是，健康状况、与辅助疗法使用有关的卫生服务因素、特定疾病儿童的患病率、辅助疗法对健康结果的影响以及对症治疗的使用和支出。这项研究有五个具体目标。具体目标1：在考虑到儿童的独特需求和特点以及对数据要求和方法的影响的情况下，指定一个与解决优先的儿童CAM保健服务和政策研究问题相关的儿科CAM保健服务和政策研究模式。具体目标2：开发和确认儿童CAM调查模块的认知显著性和构建有效性，适合和可行地用于一个或多个常规收集的基于人群的调查。具体目标3：经验性地评估可能预测儿童使用辅助治疗的关键儿童人口、资源和需求因素的重要性，包括儿童的年龄、性别、种族/民族、家庭收入、健康保险状况、健康状况和其他历来用于评估传统医疗保健服务利用情况的易感因素、使能因素和需求因素。具体目标4：经验性评估可能预测儿童使用辅助医疗的父母和其他卫生系统因素的重要性，包括父母人口统计数据、对孩子健康风险的认知、父母自我护理行为、父母报告的辅助医疗使用情况以及父母对孩子常规医疗质量的认知。具体目标5：评估儿童使用辅助医学对匹配年份和未来年份的使用和/或常规卫生服务使用支出以及选定的健康结果的关联和潜在影响。总的来说，这项研究将在儿童的健康状况、人口统计和社会特征以及他们对传统医疗保健的使用和经验的背景下，对CAM的使用进行研究。我们将利用新的以人口为基础的调查数据，利用足够大的样本，同时研究许多变量及其相互作用，从而纳入以前没有一起研究的因素。具体来说，这项研究将使用2007年全国健康访谈调查（NHIS）的数据，这是第一次在儿童版本中加入CAM补充。我们将把儿童层面的数据与2007年成人NHIS/CAM补充和其他NHIS数据以及与之匹配的年度医疗支出小组调查数据集（MEPS）联系起来。研究结果将有助于建立目前尚处于萌芽阶段的卫生服务知识基础，为将辅助医学应用日益纳入儿科护理提供信息，并将在一系列同行评议的出版物和其他产品中进行总结。

DESCRIPTION (provided by applicant): To date suggest that complementary and alternative medicine (CAM) use is increasingly common among children and youth in the United States. However, national, population-based estimates and correlates of CAM use for all and diverse subgroups of children are not known. Especially incomplete is knowledge of health status, health services factors related to CAM use, prevalence among children with specific conditions, the impact of CAM on health outcomes and utilization and expenditures for allopathic care. This study has five specific aims. Specific Aim 1: Specify a pediatric CAM health services and policy research model relevant to address priority pediatric CAM health services and policy research questions, taking into account unique needs and characteristics of children and implications for data requirements and methods. Specific Aim 2: Develop and confirm the cognitive salience and construct validity of pediatric CAM survey modules suitable and feasible for use in one or more routinely collected population-based surveys. Specific Aim 3: Empirically evaluate the significance of key child level demographic, resource and need based factors that may predict the use of CAM in children, including the child's age, sex, race/ethnicity, family income, health insurance status, health status and other predisposing, enabling and need based factors historically used in evaluating conventional medical care services utilization. Specific Aim 4: Empirically evaluate the significance of parental and other health system factors that may predict the use of CAM in children, including parental demographics, perceptions of their child's health risk, parental self-care behaviors, parental reported use of CAM and parental perceptions of the quality of conventional medical care for their child. Specific Aim 5: Evaluate associations and the potential impact of CAM use in children on both their matched year and future year utilization and/or expenditures for conventional health services use and selected health outcomes. Overall, this study will place the use of CAM in children in the context of their health status, demographics and social characteristics and their use and experiences with conventional medical care. We will incorporate factors not studied together previously by capitalizing on new population-based survey data about children's use of CAM with a sufficiently large sample to permit studying many variables and their interactions simultaneously. Specifically, this study will use data from the 2007 National Health Interview Survey (NHIS), which for the fist time includes a CAM supplement to the child version. We will link this data at the child level to the 2007 adult NHIS/CAM supplement and other NHIS data as well as to the matched year Medical Expenditure Panel Survey dataset (MEPS). Study findings will contribute to the currently nascent foundation of health services knowledge to inform the increasing integration of CAM use into pediatric care and will be summarized in a series of peer reviewed publications and other products. PUBLIC HEALTH RELEVANCE: This study employs available national data to empirically evaluate factors associated with children's use of CAM and the potential impact of CAM use on outcomes and utilization of allopathic medicine. Standardized research models and methods will be developed to advance clinical, public health and translational health services research.